Systems and methods for passing a racking hitch through tissue

Abstract

A suture loop is used in combination with a grasp-and-retrieve suture passer to pass a racking hitch through tissue in one step.

What is claimed is: 
     
       1. A method of creating a racking hitch suture stitch through a portion of tissue, comprising:
 loading a suture loop into a jaw of a clamping mechanism of a suture passer, wherein the clamping mechanism comprises a pair of jaws relatively movable with respect to one another between a closed clamping position and an open position; 
 passing a shaft of the suture passer through the suture loop; 
 securing a portion of the suture loop using a suture spring clip; 
 positioning the clamping mechanism, in its open position around tissue through which the suture loop is to be passed, at a procedural site; 
 closing the clamping mechanism to pass the suture loop through the tissue; and 
 pulling the suture passer proximally out of the procedural site, thereby releasing the suture loop from the suture spring clip so that the released portion of the suture loop slides distally down the suture passer shaft and tightens in a racking hitch around the tissue. 
 
     
     
       2. The method of  claim 1 , wherein closing the clamping mechanism comprises manipulating an actuator operable for moving the pair of jaws between the open and closed positions. 
     
     
       3. The method of  claim 2 , wherein the actuator is a trigger that extends from a handle of the suture passer. 
     
     
       4. The method of  claim 1 , wherein the suture loop comprises a continuous loop of suture. 
     
     
       5. The method of  claim 1 , wherein the suture loop comprises a single strand tail of suture connected to a loop of suture. 
     
     
       6. The method of  claim 5 , wherein loading the suture loop into the jaw of the clamping mechanism comprises loading the tail into a passer jaw of the pair of jaws. 
     
     
       7. The method of  claim 6 , wherein the tail of the suture loop is inserted through an aperture of the passer jaw. 
     
     
       8. The method of  claim 6 , further comprising cutting the tail, after pulling the suture passer proximally out of the procedural site, to provide two free ends of suture. 
     
     
       9. The method of  claim 8 , further comprising loading the two free ends of suture into two different anchors. 
     
     
       10. The method of  claim 8 , further comprising loading one or both of the two free ends of suture into a knotless anchor. 
     
     
       11. The method of  claim 1 , wherein the pair of jaws comprises a passer jaw and a top jaw, the top jaw movable relative to the passer jaw about a transverse pivot axis between the closed position and the open position. 
     
     
       12. The method of  claim 1 , wherein the racking hitch provides a secure hold on the tissue that tightens as tension is applied. 
     
     
       13. The method of  claim 1 , wherein the suture spring clip comprises a leaf spring. 
     
     
       14. A method of creating a racking hitch suture stitch through a portion of tissue, comprising:
 loading a suture loop into a first jaw of a clamping mechanism of a suture passer, wherein the clamping mechanism comprises the first jaw and a second jaw relatively movable with respect to the first jaw between a closed clamping position and an open position; 
 passing a shaft of the suture passer through the suture loop; 
 positioning the clamping mechanism, in its open position around tissue through which the suture loop is to be passed, at a procedural site; 
 closing the clamping mechanism to pass the suture loop through the tissue; and 
 pulling the suture passer proximally out of the procedural site, thereby releasing the suture loop from a suture spring clip so that the released portion of the suture loop slides distally down the suture passer shaft and tightens in a racking hitch around or through the tissue. 
 
     
     
       15. The method of  claim 14 , wherein the suture loop comprises a continuous loop of suture. 
     
     
       16. The method of  claim 14 , wherein the suture loop comprises a single strand tail of suture connected to a loop of suture. 
     
     
       17. The method of  claim 16 , wherein loading the suture loop into the first jaw of the clamping mechanism comprises loading the tail into the first jaw. 
     
     
       18. The method of  claim 17 , wherein the tail of the suture loop is inserted through an aperture of the first jaw. 
     
     
       19. The method of  claim 14 , wherein the suture spring clip comprises a leaf spring.